The most commonly asked question online and at home visits is how to maximize milk supply. In the hospital where I worked almost every single breastfeeder would be convinced that they didn’t have enough milk. Most often it had to either to do with the confusion between normal milk production amounts, and that 60ml bottle of formula they see in the bassinet drawer, or having a fussy, overwhelmed baby at 2am with some sweet nurse offering formula for your baby to put them into a food coma. With help like that no wonder so many people think their milk production is low from the start.
If you are able to prepare for your baby’s arrival and get good information prior to giving birth the normal amounts of breastmilk don’t look inadequate because you’ll know what to expect.
Your body produces milk starting in the 2nd trimester. This production is to ensure the milk is right there no matter when your baby arrives. It’s tied to their development and it’s why breastmilk can change its composition to meet their individual needs right from the moment of birth on.
First day of life your baby will take in between 5 and 15ml ( the size 1-3 US nickels) in the first 24 hours. They are expected to have at least 1 wet and 1 poopy diaper in that first 24 hours. It’s important to feed your baby several times in those first few hours after birth. After that they can be hard to wake, but offering the breast and using hand expression to help get milk in them will help them get what they need. Offer both breasts at each feeding.
Pro tip: babies can be easily overwhelmed by noise and light. Keep the lights low and visitors to a minimum. This helps with 2am screamies and with difficulty waking them for feedings.
I hate to be the first to tell you, but whatever times your baby was most active while they were inside is the same schedule they will have the first few weeks. It takes about a month for your baby to learn your circadian rhythm so, get to know late night tv and napping during the day.
Heading into day 2 babies will be more awake and may cluster feed (especially at night). If your baby is circumcised or has any medical procedure they are often given sugar water and will sleep for several hours and may sleep through a few feedings. They might not be able to wake up enough to be syringe fed. Don’t worry. They’ll make it up once they wake up by cluster feeding, and loudly telling you about their experience. Listen empathically and take comfort shifts with a partner or helper when possible.
From here offer both breasts at each feeding every 2 to 3 hours or more often if your baby wants to nurse. Babies who struggle with staying latched by popping on and off, may need a good burp, especially if they’ve been crying.
Day 2 they have feedings of about 20 to 30mls in the 2nd 24 hours of life, and will need to have at least 2 wet and 1-2 (US quarter sized) poops.
Continue this routine until at least 2 weeks. Once they’ve returned to birth weight you can strictly go to feeding when baby requests it, but it is likely to still be about every 2-3 hours. Watch for diaper output to confirm adequate intake.
Day 3 – 3 wet, 2 poops
Day 4 – 4 wet, 2 poops
Day 5 – 5 wet, 2 poops
Day 6 and beyond – 6 wet and 2 to 3 poops.
The more often you feed your baby in the beginning the faster your supply will increase to meet their needs.
If you have any concerns during this phase get help as soon as possible. A lot of the times you just need confirmation that you are making enough and they are feeding well. But, if you have pain, your baby isn’t making adequate diaper output, or you are just worried and can’t put your finger on what it is – please find an IBCLC to help. That’s what we’re here for.
The longer you allow a problem to continue before getting help the longer it will take to be where you want to be. The vast majority of breastfeeding problems are easily solved with quality lactation support. If you want to breastfeed you deserve to have it be pain and problem free.